523098e.pdf (6/20)

City of Vantaa | Health and Social Welfare department

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INSTRUCTIONS FOR SPECIAL DIET IN SCHOOLS AND EDUCATIONAL INSTITUTIONS (Use the form attached to these instructions to notify of a special diet) Schools and educational institutions arrange their students’ special diets for medical reasons, primarily based on a medical report. The guardian (of an under-18-year-old student) shall notify the special diets on the attached form. In order to get the special diet, the medical report and special diet form shall be delivered to the student’s school three weeks before the beginning of school. Guardians shall inform schools and educational institutions of their children's risk of anaphylaxis, use of potential adrenaline shots, and how they should be treated if they accidentally eat such foodstuffs that are to be avoided. Please give the information on your child's potential adrenalin shots and other medicines, if any, on a separate form. A medical report is not required for low-lactose, lactose-free, vegetarian or vegan diet. A medical certificate does not have to be delivered each year, if the doctor has specified a validity for the special diet or if the special diet is permanent (e.g., diabetes, celiac disease, fish or nut allergy). Notification of a conviction- and ethics-based diet shall be entered in the basic information form at the beginning of the fall term. The school will deliver the information on the diet to the school's kitchen. Students studying at Vantaa schools and educational institutions shall acquire their medical report from the doctor/other party treating them. If the schoolchild or student receives no follow-up treatment related to the special diet, the family shall contact its own health center to get the medical report. Furthermore, a school doctor can write the report in connection with a standard health check. As a general rule, the medical report must have been given within six months before the school year begins, unless the doctor that provided the report had specified a longer validity. The medical report will be returned to the student after the health check. The school will deliver the medical report and special diet form to the school nurse, as well as a copy of the special diet form to the school’s kitchen. The school will appropriately file the special diet forms. This procedure will ensure that the information on the schoolchild's or student’s diet is up-to-date and that the appropriate parties will be aware of the special diet when circumstances change. IMPLEMENTING SPECIAL DIETS Diabetes The meals are the same as those for other schoolchildren or students. When required, the guardian shall deliver a diabetic’s personal meal plan to the teacher and the kitchen. When required, the guardian shall agree on a meeting with the person responsible for kitchen operations as well as the school or educational institution’s staff. During the meeting, the parties agree on meals, potential snacks, and juices required for treating acute cases of hypoglycemia. Students at schools and educational institutions are mainly themselves responsible for portioning the food. The teacher overseeing the meal will help, when required. Celiac disease Wheat, rye and barley will be replaced with gluten-free grain and gluten-free products whose analyzed gluten contents fall below 20 mg/kg. With the guardians' permission, the school or educational institution will serve food containing gluten-free oats or gluten-free wheat starch. Lactose intolerance Lactose-containing milk products will be replaced with low-lactose or lactose-free ones. Low-lactose milk/buttermilk will be served with meals in accordance with the schoolchild's or student's tolerance. The guardians' notification will be sufficient for low-lactose diet. Vegetarian diet A vegetarian dish will be served for lunch as an alternative on a daily basis, so no separate notification is required. In addition to grain products, pulses, vegetables, fruits and berries, the vegetarian diet served also contains animal products such as milk products and eggs (lacto-ovo-vegetarian diet). Vegan diet If a schoolchild/student follows a vegan diet, notify the diet at the beginning of the fall term in the student information notification. The school will deliver the information on the diet to the school's kitchen. Kela-compensated clinical nutrient preparations and other dietary supplements by prescription Schoolchildren and students shall themselves bring the required clinical nutrient preparations or other individual products prescribed by a doctor, as well as agree with the class teacher or other employee on potentially keeping the products at school.

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FOOD ALLERGIES OF CHILDREN AND THE YOUNG I) Mild passing reactions: Vegetables and fruits often give rise to mild allergic reactions—such as itching of the mouth and flushing of skin—especially in children and the young suffering from pollinosis and atopic dermatitis. The majority of vegetables and fruits causing mild reactions are good to eat when cooked. Food-additive and spice allergies are extremely rare, and mildly or moderately spiced food served at schools is usually suitable for children suffering from atopic dermatitis or food allergy. It is important for children and the young to learn to eat in a versatile manner. If many foodstuffs are excluded from a schoolchild's diet, it is difficult to provide him or her with a nutritionally well-balanced diet, and it is also difficult for him/her to learn to eat in a versatile manner. If vegetables and fruits are largely excluded from a child's or young person's diet, he or she may not gain a sufficient amount of several vitamins and minerals and may, in addition, be predisposed to excessive weight gain. Therefore, schools and educational institutions aim to exclude from schoolchildren’s and students’ diet only those foodstuffs that have been proven to cause such detriment to them that their exclusion is justified. II) Severe allergies and reactions: In case of food allergies, list the foodstuffs to be avoided, which cause severe reactions or oral mucosa symptoms, respiratory symptoms, skin reactions, or intestinal disorders, on the form. If your child's diet is particularly restricted, attach his or her personal diet plan to the notification. An allergy diet is based on a doctor's diagnosis, and a medical report is required. Milk, egg, wheat, fish and nuts are the most common foodstuffs causing severe allergic reactions. Schools and educational institutions will replace nutritionally essential foodstuffs with foodstuffs suitable for children or young people with allergies. Early childhood education will require a medical report for all the foodstuffs to be avoided, even if they were not essential and not replaced with other foodstuffs. Guardians shall inform schools and educational institutions of their children's risk of anaphylaxis, use of potential adrenaline shots, and how they should be treated if they accidentally eat such foodstuffs that are to be avoided. Please give the information on your child's potential adrenalin shots and other medicines, if any, on a separate form. Be sure to always test new foodstuffs at home, not at the school or educational institution If you have any questions about how the school or educational institution implements your child's diet, contact first the student’s own teacher or nurse. If you need counseling about putting together or expanding your child's diet, you can contact the City of Vantaa's dietician: Mervi Isoherranen, tel. 040 185 6730 (Mon at 12:00-13:00). Further information on children's food allergies: Current Care Guidelines: Food allergy (children) / for the patient (www.kaypahoito.fi), 2015 Children's food allergy guidelines (www.allergia.fi)

City of Vantaa | Health and Social Welfare department

NOTIFICATION OF SPECIAL DIET Schools and educational institutions

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Basic information on child

Last name Date of birth

First name

School and class / Educational institution and group

Guardian

Tel. Email

Special diet due to health reasons Requires a medical report

Diabetes (personal meal plan as an appendix, when required)Celiac disease

does not tolerate oat,gluten-free oat is suitabledoes not tolerate gluten-free wheat starch

Food allergy with severe symptoms Adrenalin injection as auxiliary medicine

Forbidden foodstuff

Risk of anaphylaxis, that is, life-threatening allergic reaction

Other special diet due to health reasons Requires a medical report

Other diet Low-lactose lsubstitute milk: low-lactose lactose-free

Lactose-free congenital lactase deficiency (CLD)

Other considerations

AbsencesInform the school immediately of absences, so that the kitchen can be informed of them.

Medical certificate has been presented to the public-health nurse

Date Public-health nurse's signature

Guardian's date and signature

Date Public-health nurse's signature

Kitchen has received the form

Date Signature

*By signing this form I permit the school to provide the school's kitchen with a copy of this form. The original form will be filed at the school.